West Virginia is committed to developing an effective community-based system of care for children and adolescents with severe emotional disturbances and their families. The State proposes to develop model systems of care at four local sites. Two additional communities will serve as comparison sites. The model systems of care will incorporate CASSP core values and principles and are consistent with the State's CASSP plan and 99-660 Mental Health Plan. The major research question is what is the relative effectiveness of a coordinated community-based system of care in a rural state compared to the traditional service delivery system. The State's proposal is designed to test the hypothesis that if a range of appropriate services are developed, interagency planning and "gatekeeping" occur, individualized service plans are developed, and flexible "wrap-around" funds are available for youth with severe emotional problems, then the system will produce (1) better client outcomes, (2) less restrictive placements, and (3) improved parent satisfaction. The target population for the project will be children and adolescents with severe emotional disturbances who have been or are at imminent risk of being removed from their homes. Eligible youth must be under age 18 and have exhibited dysfunctional behavior at home, school, or in the community for at least one year. Subjects at four treatment sites will be compared in a pre-post design with comparable youth with severe emotional disturbances at two comparison sites on measures of client functioning, restrictiveness of environment, systems change, and parental satisfaction. Project implementation will be monitored carefully at the four treatment sites. There will be no intervention at the comparison sites, except for periodic administration of instruments measuring the study hypotheses. Clients in the comparison group will continue to receive the services currently available.